@article{ref1,
title="Association of injury history and incident injury in cadet basic military training",
journal="Medicine and science in sports and exercise",
year="2016",
author="Kucera, Kristen L. and Marshall, Stephen W. and Wolf, Susanne H. and Padua, Darin A. and Cameron, Kenneth L. and Beutler, Anthony I.",
volume="48",
number="6",
pages="1053-1061",
abstract="PURPOSE: To determine the association between injury history at enrollment and incident lower extremity (LE) injury during cadet basic training among first-year military cadets. <br><br>METHODS: Medically treated LE injuries during cadet basic training documented in the Defense Medical Surveillance System (DMSS) were ascertained in a prospective cohort study of three large U.S. military academies from 2005-2008. Both acute injuries (ICD-9 codes in the 800-900s, including fracture, dislocations, sprains/strains) and injury-related musculoskeletal injuries (ICD-9 codes in the 700s, including inflammation and pain, joint derangement, stress fracture, sprain/strain/rupture, and dislocation) were included. Risk ratios (RR) and 95% confidence intervals (CI) were computed using multivariate log-binomial models stratified by gender. <br><br>RESULTS: During basic training there were 1,438 medically treated acute and 1,719 musculoskeletal-related LE injuries in the 9,811 cadets. The most frequent LE injuries were sprains/strains (73.6% of acute) and inflammation and pain (89.6% of musculoskeletal-related). The overall risk of incident LE injury was 23.2% [95%CI: 22.3%, 24.0%]. Cadets with a previous history of LE injury were at increased risk for incident LE injury. This association was identical in males (RR=1.74 [1.55, 1.94]) and females (RR=1.74 [1.52, 1.99]). In site-specific analyses, strong associations between injury history and incident injury were observed for hip, knee ligament, stress fracture, and ankle sprain. Injury risk was greater (p<0.01) for females (39.1%) compared to males (18.0%). The elevated injury risk in females (RR=2.19 [2.04, 2.36]) was independent of injury history (adjusted RR=2.09 [1.95, 2.24]). <br><br>CONCLUSION: Injury history upon entry to the military is associated with incidence of LE injuries sustained during cadet basic training. Prevention programs targeted at modifiable factors in cadets with a prior history of LE injury should be considered.<p /> <p>Language: en</p>",
language="en",
issn="0195-9131",
doi="10.1249/MSS.0000000000000872",
url="http://dx.doi.org/10.1249/MSS.0000000000000872"
}